术前灌注吡柔比星对非肌层浸润性膀胱癌预后的影响

发布时间：2018-10-25 10:52

【摘要】：目的：评价术前予吡柔比星膀胱灌注对非肌层浸润性膀胱癌患者的复发和进展的影响。方法：收集135例行经尿道膀胱肿瘤电切术(TUR-BT)治疗的非肌层浸润性膀胱癌患者。根据纳入和排除标准,最后获得符合标准的120例患者。灌注组40人,术前半小时用吡柔比星30mg+5%葡萄糖50m1行膀胱灌注,而后行TUR-BT;对照组80例,术前未予膀胱灌注。灌注组和对照组均于TUR-BT术后2周开始用吡柔比星30mg+5%葡萄糖50m1行膀胱灌注,1次/周,共8周；而后1次/月,至术后1年,术后均随访1年,每3个月行膀胱镜检查明确肿瘤有无复发、进展。结果：随访术后1年内,灌注组40例复发7例,复发率17.5%,进展2例,进展率5%；对照组80例复发28例,复发率35%,进展6例,进展率7.5%。在EORCT评分表分组的中危组中,两组的复发率分别为16.8%和36.7%。两组的总体进展率的差异无统计学意义；两组总体复发率和EORCT评分表分组的中危组中的差异具有有统计学意义(P0.05)。结论：术前行吡柔比星膀胱灌注能降低非肌层浸润性膀胱癌术后1年的复发率,尤其是按EROCT评分表分组的中危组的患者,是降低非肌层浸润性膀胱癌术后复发率的一个有效方法。
[Abstract]:Objective: to evaluate the effect of intravesical instillation of pirarubicin on recurrence and progression of non-myometrial invasive bladder cancer. Methods: a total of 135 patients with non-muscular invasive bladder cancer were treated with transurethral resection of bladder tumor (TUR-BT). According to the inclusion and exclusion criteria, 120 patients who met the criteria were obtained. 40 patients in the perfusion group received intravesical instillation of pirarubicin 30mg 5% glucose 50m1 half an hour before operation, and 80 patients in the TUR-BT; control group were given intravesical perfusion without intravesical instillation before operation. Both the perfusion group and the control group received intravesical instillation of pirarubicin 30mg 5% glucose 50m1 at 2 weeks after TUR-BT for 8 weeks, followed by 1 month to 1 year after operation. Cystoscopy was performed every 3 months to determine the recurrence and progression of the tumor. Results: within one year of follow-up, there were 7 cases of recurrence, 17.5% of recurrence, 2 cases of progression and 5 cases of progression in perfusion group, while in the control group, there were 28 cases of recurrence, 35% of recurrence rate, 6 cases of progression, and 7.5% of progress rate. The recurrence rates of the two groups were 16.8% and 36.7%, respectively. There was no significant difference in the overall progression rate between the two groups; there was significant difference in the overall recurrence rate between the two groups and in the middle risk group in the EORCT scoring table (P0.05). Conclusion: preoperative intravesical instillation of pirarubicin can reduce the recurrence rate of non-myometrial invasive bladder cancer 1 year after operation, especially in the moderate risk group according to the EROCT score. It is an effective method to reduce the recurrence rate of non-myometrial invasive bladder cancer.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R737.14

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